Jeremy A Guggenheim1, Cathy Williams2, Kate Northstone2, Laura D Howe3, Kate Tilling3, Beate St Pourcain4, George McMahon4, Debbie A Lawlor3. 1. Centre for Myopia Research, School of Optometry, Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China. 2. School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. 3. School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom. 4. MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom.
Abstract
PURPOSE: More time outdoors is associated with a lesser risk of myopia, but the underlying mechanism is unclear. We tested the hypothesis that 25-hydroxyvitamin D (vitamin D) mediates the protective effects of time outdoors against myopia. METHODS: We analyzed data for children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort: noncycloplegic autorefraction at age 7 to 15 years; maternal report of time outdoors at age 8 years and serum vitamin D2 and D3 at age 10 years. A survival analysis hazard ratio (HR) for incident myopia was calculated for children spending a high- versus low-time outdoors, before and after controlling for vitamin D level (N = 3677). RESULTS: Total vitamin D and D3, but not D2, levels were higher in children who spent more time outdoors (mean [95% confidence interval (CI)] vitamin D in nmol/L: Total, 60.0 [59.4-60.6] vs. 56.9 [55.0-58.8], P = 0.001; D3, 55.4 [54.9-56.0] vs. 53.0 [51.3-54.9], P = 0.014; D2, 5.7 [5.5-5.8] vs. 5.4 [5.1-5.8], P = 0.23). In models including both time outdoors and sunlight-exposure-related vitamin D, there was no independent association between vitamin D and incident myopia (Total, HR = 0.83 [0.66-1.04], P = 0.11; D3, HR = 0.89 [0.72-1.10], P = 0.30), while time outdoors retained the same strong negative association with incident myopia as in unadjusted models (HR = 0.69 [0.55-0.86], P = 0.001). CONCLUSIONS: Total vitamin D and D3 were biomarkers for time spent outdoors, however there was no evidence they were independently associated with future myopia. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
PURPOSE: More time outdoors is associated with a lesser risk of myopia, but the underlying mechanism is unclear. We tested the hypothesis that 25-hydroxyvitamin D (vitamin D) mediates the protective effects of time outdoors against myopia. METHODS: We analyzed data for children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort: noncycloplegic autorefraction at age 7 to 15 years; maternal report of time outdoors at age 8 years and serum vitamin D2 and D3 at age 10 years. A survival analysis hazard ratio (HR) for incident myopia was calculated for children spending a high- versus low-time outdoors, before and after controlling for vitamin D level (N = 3677). RESULTS: Total vitamin D and D3, but not D2, levels were higher in children who spent more time outdoors (mean [95% confidence interval (CI)] vitamin D in nmol/L: Total, 60.0 [59.4-60.6] vs. 56.9 [55.0-58.8], P = 0.001; D3, 55.4 [54.9-56.0] vs. 53.0 [51.3-54.9], P = 0.014; D2, 5.7 [5.5-5.8] vs. 5.4 [5.1-5.8], P = 0.23). In models including both time outdoors and sunlight-exposure-related vitamin D, there was no independent association between vitamin D and incident myopia (Total, HR = 0.83 [0.66-1.04], P = 0.11; D3, HR = 0.89 [0.72-1.10], P = 0.30), while time outdoors retained the same strong negative association with incident myopia as in unadjusted models (HR = 0.69 [0.55-0.86], P = 0.001). CONCLUSIONS: Total vitamin D and D3 were biomarkers for time spent outdoors, however there was no evidence they were independently associated with future myopia. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
Entities:
Keywords:
epidemiology; light levels; myopia; refractive error; vitamin D
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